Information Collection

OWCP Customer Feedback at Outreach Event for Division of Energy Employees Occupational Illness Compensation (Paper)

IC 253764 under ICR 202312-1225-004 · OMB 1225-0093.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1225-0093 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
OWCP Customer Feedback at Outreach Event for Division of Energy Employees Occupational Illness Compensation (Paper)	Form and Instruction
Customer Feedback at Outreach Event for Division of Ener Outreach Event Survey.pdf	Form and Instruction
Customer Feedback at Outreach Event for Division of Ener Outreach Event Survey.pdf	Form and Instruction
ICR A11 Section 280 Clearance - DEEOIC Outreach Event Survey 2022.docx 1225-0093 Supporting Statement - Customer Feedback at Outreach Event for Division of Energy Employees Occupational Illness Compe	IC Document
ICR A11 Section 280 Clearance - DEEOIC Outreach Event Survey 2022.docx 1225-0093 Supporting Statement - Customer Feedback at Outreach Event for Division of Energy Employees Occupational Illness Compe	IC Document

IC Title:

OWCP Customer Feedback at Outreach Event for Division of Energy Employees Occupational Illness Compensation (Paper)

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	Customer Feedback at Outreach Event for Division of Energy Employees Occupational Illness Compensation (DEEOIC)	Outreach Event Survey.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 600

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	600	600
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
1225-0093 Supporting Statement - Customer Feedback at Outreach Event for Division of Energy Employees Occupational Illness Compensation (DEEOIC)	ICR A11 Section 280 Clearance - DEEOIC Outreach Event Survey 2022.docx	05/20/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.